Comorbidity High Among Adults With Epilepsy

Pauline Anderson

October 31, 2013

Adults with epilepsy report suffering cardiovascular and respiratory disorders, some inflammatory conditions, and joint and other types of pain more frequently than those without epilepsy, according to a 2010 National Health Interview Survey (NHIS).

Results of the survey were published in the November 1 issue of the Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report.

"The added challenges of managing multiple comorbidities among adults with epilepsy can further threaten their well-being and ability to function optimally," the authors, with first author Norbert T. Kadima, Mstat, SciMetrika, Research Triangle Park, North Carolina, and corresponding author Rosemarie Kobau, MPH, MAPP, from the Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion at CDC, conclude. "Thus, improved awareness and understanding among neurologists and primary-care providers regarding the common medical comorbidities reported with epilepsy along with better screening, diagnosis, and treatment of comorbidity in persons with epilepsy are necessary."

The CDC analyzed data from adults aged 18 years and older who responded to the NHIS, an annual cross-sectional survey of the civilian, noninstitutionalized US population

The survey found that the age-adjusted prevalence of any heart disease was 18.3% (95% confidence interval [CI] 14.7% - 22.6%) among adults with any epilepsy, defined as ever having been told by a physician or other health professional that they had a seizure disorder or epilepsy, compared with among those without epilepsy (11.3%; 95% CI, 10.9% - 11.8%).

Adults with any epilepsy were more likely to have been told they had hypertension (34.2%) and to have had a stroke (14.3%) than those without epilepsy (29.0% and 2.4%, respectively). In addition, more adults with epilepsy (7.1%) had prediabetes than adults without epilepsy (4.3%), and they were more likely to be obese.

Respiratory Disorders

As for respiratory disorders, more adults with epilepsy (5.5%) had emphysema than those without the disorder (1.7%), in addition to increased rates of chronic bronchitis.

Some disorders that can be caused or mediated by inflammation, for example, dermatitis, arthritis and joint stiffness and pain, and other types of pain such as migraine, were also more common in adults with epilepsy.

Cancer was more common in adults with epilepsy (11.3%) than in adults without epilepsy (8.1%), as well, and patients with epilepsy also were more likely to have had peptic ulcer disease and a liver condition.

"These disorders might result from shared disease mechanisms (e.g., migraine or stroke), social disadvantages associated with chronic disease (e.g., risk-factor clustering), treatment side effects (e.g., weight gain) or shared genetic, environmental, or other factors," the authors write.

The findings have a number of limitations, including possible reporting bias, misclassification of some seizures as epilepsy, and underreporting or overreporting of associations because of low response rates, they note.

Morb Mortal Wkly Rep. 2013;62:849-853. Full text

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